Individual
JILL ARCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
6504 NE SISKIYOU ST, PORTLAND, OR 97213-4572
(503) 327-3819
(503) 286-7939
Mailing address
6504 NE SISKIYOU ST, PORTLAND, OR 97213-4572
(503) 327-3819
(503) 286-7939
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
17781
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17781
17781
OR
Enumeration date
09/14/2016
Last updated
09/14/2016
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